11060038 CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10165 N DE ANZA BLVD CONTRACTOR:S D DEACON CORP OF PERMIT NO: 11060038
CALIFORNIA
OWNER'S NAME: INFINITE LOOP HOTEL LLC 7745 GREENBACK LN STE 250 DATE ISSUED: 11/17/2011
ER'S PHONE: 4086213094 CITRUS HEIGHTS,CA 95610 PHONE NO:19161969,0900
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG r ELECT r PLUMB r
License Cla"_" Lic.N_/�f,/�7�_ MECH r RESIDENTIAL r r
/1 COMMERCIAL
Contractor f�ita./ Date ll) l-1J/�I
1 hereby affirm that 1 am licensed un11Jer the provisiodrif Chnpter 9 JOB DESCRIPTION:CONSTRUCT NEW SUBSTRUCTURE-29.293 SF
(commencing with Section 7000)of Division 3 of the Business&Professions CONSISTING OP
STRUCI'URE
Code and that my license is in full force and effect. UNDERGROUND PARKING FOR FUTURE:
HOTEL. SUPERSTRUCTURE TO BE UNDERR A A SEPARATE
hereby affirm under penalty of perjury one or the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued Sq.Ft Floor Area: Valuation:$2000000
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:32634057.00 Occupancy Type:
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may acerae against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Secfian 180 DAYS FROM LAST CALLED INSPECTION.
9.18. J
Signaturey'
_ Date 1 / l 7 1 Issued b ��� Date /
OWNER-BUILDER DECLARATION
1 hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall he inspected prior to any roofing material being installed Ira roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,olid the sumcture is not intended or offered for sale(See.7044, inspection.
Business&Professions Code)
I,as owner of the property,am exclusively contracting with licensed contractors to Signature of ApplimnC_ Dale:
construct the project(Sec.7044,Business&Professions Code).
hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. 1 have read the hazardousl[materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California health&Safety Code,Sections 25505,25533,and 25534. 1 will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
p Safety Code,Section 25532(a)should 1 store or handle hazardous material,
permit is issued. Additionally,should 1 use equipment or devices which emit hazardous air
I certify that in the pertomtance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District 1 will
not employ any person in any manner so as to become subject to the Worker's maintain compliance withithe Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of Califomia. If,alter making this certificate of exemption,I health&Safety Code,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions ofthe Labor Code,I must
forthwith comply With such provisions or this permit shall he deemed revoked. O rer or uthori egen. 1/
Date:
APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is
correct. I agree to comply with all city and county ordinances and state laws relating I hereby affimt that there is a construction lending agency for the performance of work's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
s,and expenses which may accrue against said City in consequence of the Lender's Address
ting ofthis permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DF,CLARATION
9.18.
1 understand my plansshall be usedas public records.
Signature Date
Licensed Professional
CITY OF CUPERTINO'BUILDING PERMIT DATE
'BUILDING ADDRESS- 10 f65 N-DE ANZA.BLVD CONTRACTOR:"S D DEACON CORP`OF PERMIT NOt 11060038
CALIFORNIA
Y
OWNER'S'.NAME: INF,,INITE;160P-.H0TEL LLC 7745 GREENBACK LN STE 250, DATE ISSUED:d 1%1,7/201.1
�O,WN,ER'SIPHQNE:.4086213094 CITRUS-HEIGHTS,,,CA 95610 PHONE N0::(916)969.-0900.
<] LICENSEDaCONTRACTOR'S:DECLA'RATION BUILDING PERMIT INFO: BLDC: ELECT PLUMB
License ClassA3- Lic-* 'r 4,eP q 7 S
MECH ' RESIDENTIAL� COMMERCIAL
Contractor :'�� OLk—) Date: [O :'3'(. 'II
Lhereby,affirm thati am:licensed underttie:provisionstd' hapte179 JOB,DES,CRIPTION:;CONSTRUCT NEW SUBSTRUCTURE-29;293.SFCONSISTING OF
UNDERGROUND PARKING POW FUTURE�SUPERSTRUCTURE
(commencing with'ma GenSccion:7 010)[ force aon3 oe the Business_&:P,iofessions CDRTAIN U ER WITCT RUCT BURAL-0 7_R A SEPARATE'9/26/2012-DEF#I-DEFERRED SUBMITTAL
Code and thaty
1/2012-DEF#1 ISS'I)
I'he_rebyafrrm under penalty of perjuryone ofthe following>twod&larations:
I have and yiI14maintain a:certificate ofconsent,to self-insure;for Worker's
Compensation,as^provide&116r brSection37,00 of the Labor Code,for the
performance of the work'for,which:this permit'is,issued.
I,have,and:will maintain Wo`rker's Compensation Insurance;as piovided,for by
Section 3700 of ihelaborCode„for therperformance of the,work forwhich this Sq,Ft Floor.Area: Valuatiod:$2000000
permit is,issued.
APPLICANT.CERTIFICATION. APN Number:32634057:00 Occupancy Type:
l,'certify'that.)have read tlii's,application and state,fhaf the above infonnationtis.
correct.,[agree to,compl.y,with_all city and county`ordinances•and.state,Iawsrelating
to building;construction,and herebyauthorize representatives of.thiscity'to enter
up6h4hesabove'mentioned property fog inspection;purposes. (We)agree to save
indemnify and keep harmless the Cltyof Cupertino'against1labilities,judgments„ , PERMIT.EXPIRES IF WORK IS NOT STARTED,
costs,.and.ezpenses'which may accrue against said City in consequence'of the .
WITHIN 180 DAYS OF PFAMIT'ISSU,ANCE OR.
granting of thls!permit. Additionally,-the applicant understands,and will comply'
with all non point source regi Cations'per the Cupertmo Murtrcipal Code,Section 18Q DAYS.FROM LAST CALLED INSPECTION.
9;18.,
Signature ' Date [ Z,f Z Issued by: .�i � Date:
❑ OWNER-BUILDER DECLARATION
[;hereby aftir4hafLam exempt from the,Contractor's"License Law for>one�of RE-ROOFS:
the following two reasons:. Allroofs;shall beinspected,priorto.anyroofing material berg installed.if a roof is
I,�as owner Of the property;.or.my employeeswith'wages'as'their�sole,compensation, :rnstalled withouf.first obtaining an inspection_,[agree^to iemove�all.new materials for
inspection.
will do the work;;and'the structure`is,not,intended or;off_ered,focsale(Sec:704.4,
Business&ProfessionsCode) Sigmturetif Appnt:
lica . Date:
[,,as owner,o,f'the:property,-am-exclusively contr-actinv4ith Iicensed',contractors to,
construct<the projecC(5ec.7044,Business&,ProfessionsCode).
ALL;120QF,COVE121NGS TO BE GLASS"AAl"OR BETTER
I hereby affirm.underpenaltyof perjury one of the following three
declarations:
[:have=and will maintain a Certificate of Consentto,self-'i.nsure.for-Worker's HAZARDOUS MATERIALS DISCLOSURE
ComPensation,.as provided for.by Section:3700 ofthe,Labor'Codefor the
I haves ead the,hazardou`s r"naterials.requirements`tiifdertChapter6.9!�'of the
I, nd w IIha elamaintain Wo ker,shColmpensation'Insu ance,as�proviil'ed',forby ompl ance Iwiih the<CupernnodMynicipal Code�Ghapter 9 12 and the Health&fain
Section 3700 of the Labor Code,for the_performance of the 4ork-for,which.this. Safety Code,Section 25532(a),should[store or handle hazardous%material.
-permR;is issued. Additionally,should 1 u§e-equrpment�or devices which,emit.hazardous air
I certrfythat in the performance ofthe work forwhich this permit is issued,d'shall contaminants as defined by the Bay.Area Air Quality Managemenillistrict I will
- `maintain compliance with the Cupertino,Municipal Cod'e,,Chapter 9.12,an&the
not,,employ anyperson_m any`manner so as,.to become subject to the Worker's health 8%Safety°Code,Sections 25505,25533,,and 25534.
Compensation laws of.,Califoinia.Ifafter'making this certificateofexemption,I
become'subject,to the Worker's Compensation,provisions ofthe Labor Code,I must Owne' r aut e a
_
forthwith comply with such-provisions, orathis ermitsbalhbe deemed revoked. n'' \� �Date: �'
PYp
APPLICANT CERTIFICATION CONSTRUCTION LENDING.AGENCY
Ioertify,that I-have;read thisapplicaiion_andatate that tbe:above:information is I hereby affirm.hat,thereiisa;construction lending,agency for the performance of work's
correct.I,agree'to,comp[y.with all cityand county ordinances and state lawssrelatin
g for which'this permit Is;issued(Sec.t3097,Civ C.)
to building construction,and,.hereby,authorize;representatives�bf this city`.f6enter, Lender's,Narne
_. _....
upon°the above mentioned,bropeity for inspection purposes.(W .e)tagreeito,.save -
indemnify°and keep harmless'*the City,,of Cupertino against liabiliiiesl,'udgments, Leoder'siAddress
costs;and expenses Which,may accruelagainstsaid Cityin.consequence ofithe:
granting,of thispermit.Additionally,the`applicant.understands and will comply.
with all.non=point sou rce.regulations'per the:Cupertino Municipal Code,<_Sec_tion ARCH ITECT'S"DECLARATION
9.18. 1 undeistand:my,plans.shall be used as public'records.
Signature_ Date? Li censed.Professional
CONSTR'UC.TI'ON PE'RMIT`.APPLfC-AT1'N;
COMMUNITY DEVELOPMENT DEPARTMENT• BUILDING DIVISION'
1;0300'TORRE;AVENLIE•CLIPERTINO.', CA 950,.14;3255. ts
(408),777-3228•.FAX,•(408)777=3,333 'buildin cu ertino:or
GU'PERTIN;O" `
❑.NEW CONSTRUCTION' " ❑ ADDI-TION, ❑ ALT-ERATIONI_TI "�SIONP -FERRED � ORIGINP:L-,PERMIT.,#. 0 � •�
PROJECT ADDRESS, AP.NI#-
3
3 ` o�
�� i� L� �' E=ivtAlL
,OWNER NAME �, PHONE
STREE"T:'ADDRESS }. CITi.Y; STATE,ZIP
CONTA T NAME PHON E-MAIL
STREET ADDRESS; CITY,STATE, ZIP' AX
Lics-,)te 13
❑OWNER ❑ OWNER-BUILDER ❑ .OWNER,AGENT -CONTRACTOR ❑•CONTRACTORAGENT ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑,TENANT
CONTI.tA TOR NAME LICENSE NUMBER LICENS ,TYPE BUS.'Llt #
p Z.� :v
COMPANY NAME E-MAIL FAX
Mf
STREET ADDRESS CITY;STATE;ZIP. HON ,
07 qle,
�ARCHI CT/ENGINEER NA E LICENSE NUMBER BUS.LIC'#,
COMPANY'NAME E=MAIL FAX
'STREET•ADDRESS CITY,STATE,ZIP, y t d' PHONE.
`D ESCRI P T I ON'OF'.WORK,
•EXISTIN6USE PROPOSED USE CONSTR.'TYPE #STORIES
' USE TYPE OCC: SQ:FT.. `VAI:UATION($)
EXISTG NEW FLOOR DEMO TOTAL
AREA AREA AREA NET,'AREA
BATHROOM KITCHEN OTHER -
REMODEL AREA REMODEL AREA k1fK46DEL AREA
PORCH AREA DECK AREA TOTAL DECK/PORCH AREA, GARAGE-AREA: Lj DETACH
[]ATTACH
#,DWECLWGUNITS. 'ISA SECOND UNIT' []YES SECOND'STORY ,❑YES
HEHVGrAnI)ED?' 'E]NO` ADDITION? .❑NO
PRE-APPLICATION ❑Y'E$ IF YES_PROVIDE COPY OE. ISD BLDG-.AN ❑YES RECEIVED BY x I TOTALVALUATION:
PLANNINGAPPLN: ❑NO PLANNING APPROVAL:LEITER EICHLER HONIE?PLANNING []
-„-
By my signature belo�y,[certify to each of the following: I-am'the property owner or authotized;'agent to act on:the�property;owner's behalf. I have'read ttiis,
a,pp'li.cation�and,theAinformation(have prbiii&d.is+correct. I,have'readithe,Descriptionof Work'and�:verify it isaaccurate. I agreehto comply withaWapplicable local
oldinances;and stateaaWs relatingAto' uilding'c �udion;�r�izlw fuesenfatives of Cupertmo;to,enCer the-abo e=identified pPoperty fol inspection purposes.
Sienature of.Applicant%AgeA Date:;
SUPPLEMENTAL INFORMATION'REQUIREDPLANCHEexTYPE _.:
k, ,, ,;ROUTING SLIP
New SFD or Multifamily dwel lmgs_ Apply for delriolition pennit;foT ❑,ouER THE couNTER LTJ BUILDING PLAN iiEVIEw
exlsti_ng building(s). Demolition'permit'is required:'priorto;issuatice-ofbuilding n4
permit°for,new building. i❑ ElPRESS ; PLAN)\7NG PL1N{REVEW
1
Gommer'ciahBldg's Prov,idea.corlipletedHazardous'NlaterialsDisclosure;
form if Hazardous'Matenials'are.be_ing used as part:of;tli- project,;-” M�
0 LARGE FIREDEPT� 4 zas
Copy of.Planning;Approval'Letter or Meeting withPlamm�g;prior,to
§Ubn"Ilttal.Of Bilildin Permit a hCat10I]., � MAJOR � SANITARYsSE11tER DISTRICT .
Ming, PP "� t =z
f
4 s
BldgApp 201 hdoc,revised:O021%11
CITY OF CUPERTINO
FEE ESTIMATOR-BUILDING DIVIS°ION.
:- - .ADDRESS:, 101 65'n. de anza Blvd. DATE:: 09/2612012 REVIEWED BY.: bob s"
APNe ,BP# J., 3 "VALUATION: $0
,*.PERMIT TYPE: Buildirig Permit" PLAN CHECKTYPE: Alteration/Addition/ Repair
PRIMARY' PENTAMATION
USE Commercial Buildirig PERMIT TYPE: 16ENCO i
WORK deferred submittal.curtain wall with'structural.
SCOPE
sm
r
- �.r e �
-1 1111
eCh.Plan Check i'lruirb. Van "beck F./ii -./?ldn:Check
Tech.'Perritil f"eet Ph h2h.I'orrriil 1° e: 1��/er_-: PerrniiFee"
nthei.:17ee4f: !risj�., Orj{c rrI lurzh insfE3_L__ 0(bef Mer'lnspE3:
Insp.OFee:-
estimate does'not 'fe
iitcludees�due,to:oiherDepartments ei,e.,Planning,,Public�Works,Fire,Sanitary Sewer District,School
D 'E etas. These. ees°are based-on the, rdimina, in ormation;available dnd are{onC an_estiMate., Contact:the De"ty or dddn"?Hn o.
FEE ITEMS.(ree,Resoluiion.F1-053'EfT.;7/1/11); FEE QTy*iK'j MISC ITEMS
Plan Check Feer Hourly Only?, O Yes O;No $0.00 0 hours ;Plan Check,Hourly
Suppl..PC Fee: (F).Reg 0 OT Q;Q hrs $0.00 $532'.00 ISTPtNCK
PME,Plan Check: $0.00
Permit Fee: H.ourlyOnly? E)Yes 0�';No $0.00
Suppl. lnsp. FeecQ Reg:. .O OT Q;Q hrs $0:00
PME Unit>Fee-- $0°00
PME Permit Fee";! $0.00
Conslr.action--Tar:
�1 c�ininisti«fi_ve Fete° 0
Works Without,Permit? O Yes (F)'No $0:00 O
Advanced Planning Fee: $0.00 hours, Inspections 0
Ii ravel ioc:crrnfrnturrurr fees.: $532:00 ISTINSP Inspection„Hourly
Strong Motion Fee:. $0:00 Select an:Adininistrative"Iters
.Bld`�`.Stds Cominission Fee-
'$0.00
0.00 .1�0:64:0.01 064:00
SUBT®TALS'• $ $ , w,A TOTAL FEE: $ ;
Revised: 07./01/2012
CITY OF CUPERTINO BUILDING PERMIT
BUILDING ADDRESS: 10165 N DE ANZA BLVD CONTRACTOR:S D DEACON CORP OF PERMIT NO:11060038
CALIFORNIA
OWNER'S NAME: INFINITE LOOP HOTEL LLC 7745 GREENBACK LN STE 250 DATE ISSUED:11/17/2011
OWNER'S PHONE: 4086213094 CITRUS HEIGHTS,CA 95610 PHONE NO:(916)969-0900
LICENSED CONTRACTOR'S DECLARATION BUILDING PERMIT INFO: BLDG ELECT r PLUMB
License Class/jS Lie.#
/ :7'!r MECH RESIDENTIAL COMMERCIAL
Contractor Date L
I hereby affirm that I am licensed unter the provision of Chapter 9 JOB DESCRIPTION:CONSTRUCT NEW SUBSTRUCTURE-29,293 SF
(commencing with Section 7000)of Division 3 of the Business&Professions CONSISTING OF
Code and that my license is in full force and effect. UNDERGROUND PARKING FOR FUTURE SUPERSTRUCTURE
HOTEL. SUPERSTRUCTURE TO BE UNDER A SEPARATE
I hereby affirm under penalty of perjury one of the following two declarations:
I have and will maintain a certificate of consent to self-insure for Worker's
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued.
I have and will maintain Worker's Compensation Insurance,as provided for by
Section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. Sq.Ft Floor Area: Valuation:$2000000
APPLICANT CERTIFICATION
I certify that I have read this application and state that the above information is APN Number:32634057.00 Occupancy Type:
correct.I agree to comply with all city and county ordinances and state laws relating
to building construction,and hereby authorize representatives of this city to enter
upon the above mentioned property for inspection purposes. (We)agree to save
indemnify and keep harmless the City of Cupertino against liabilities,judgments, PERMIT EXPIRES IF WORK IS NOT STARTED
costs,and expenses which may accrue against said City in consequence of the
granting of this permit. Additionally,the applicant understands and will comply WITHIN 180 DAYS OF PERMIT ISSUANCE OR
with all non-point source regulations per the Cupertino Municipal Code,Section 180 DAYS FROM LAST CALLED INSPECTION.
9.18.
Signature Date__N/ { Issued by:
❑ OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for one of RE-ROOFS:
the following two reasons: All roofs shall be inspected prior to any roofing material being installed.If a roof is
I,as owner of the property,or my employees with wages as their sole compensation, installed without first obtaining an inspection,I agree to remove all new materials for
will do the work,and the structure is not intended or offered for sale(Sec.7044, inspection.
Business&Professions Code)
1,as owner of the property,am exclusively contracting with licensed contractors to Signature of Applicant: Date:
construct the project(Sec.7044,Business&Professions Code).
I hereby affirm under penalty of perjury one of the following three ALL ROOF COVERINGS TO BE CLASS"A"OR BETTER
declarations:
I have and will maintain a Certificate of Consent to self-insure for Worker's HAZARDOUS MATERIALS DISCLOSURE
Compensation,as provided for by Section 3700 of the Labor Code,for the
performance of the work for which this permit is issued. I have read the hazardous materials requirements under Chapter 6.95 of the
I have and will maintain Worker's Compensation Insurance,as provided for by California Health&Safety Code,Sections 25505,25533,and 25534. I will maintain
Section 3700 of the Labor Code,for the performance of the work for which this compliance with the Cupertino Municipal Code,Chapter 9.12 and the Health&
Safety Code,Section 25532(a)should I store or handle hazardous material.
permit is issued. Additionally,should I use equipment or devices which emit hazardous air
I certify that in the performance of the work for which this permit is issued,I shall contaminants as defined by the Bay Area Air Quality Management District I will
not employ any person in any manner so as to become subject to the Worker's maintain compliance with the Cupertino Municipal Code,Chapter 9.12 and the
Compensation laws of California. If,after making this certificate of exemption,I Health&Safety Code,Sections 25505,25533,and 25534.
become subject to the Worker's Compensation provisions of the Labor Code,I must
forthwith comply with such provisions or this permit shall be deemed revoked. O er or uthori ager . /
9000 Date:T_�
if V APPLICANT CERTIFICATION CONSTRUCTION LENDING AGENCY
I certify that I have read this application and state that the above information is
correct.I agree to comply with all city and county ordinances and state laws relating I hereby affirm that there is a construction lending agency for the performance of wrk's
to building construction,and hereby authorize representatives of this city to enter for which this permit is issued(Sec.3097,Civ C.)
upon the above mentioned property for inspection purposes.(We)agree to save Lender's Name
indemnify and keep harmless the City of Cupertino against liabilities,judgments,
costs,and expenses which may accrue against said City in consequence of the Lender's Address
granting of this permit.Additionally,the applicant understands and will comply
with all non-point source regulations per the Cupertino Municipal Code,Section ARCHITECT'S DECLARATION
9.18.
I understand my plans shall be used as public records.
Signature Date
Licensed Professional
CON TRUCTION PERMIT APPLICATION
CQMMONITY DEVELOPMENT_DEPA'RTMENT?'BUILDING DIVISION
1,0300 TORRE;.AUENUE -�CUPERTINO, CA 95014-3255
;.CIU P 0 RT 1140
(408),77'7-3228•'FAX(408)777,3333,•building[))cupertino.org
VNEWCONSTRUCTION _❑ ADDITION ❑ ALTERATION TI ❑ R&UISION,/DEFERRED ORIGINALTERMITk
PROJECT ADDRESS•1O"1�6 5 -N.. .DE ANZA. .APN H
. .326-'34-057
,OWNER,NAME - PHONE E-�1A1
I-NFTMI,TE LOOP HOTEL' LLC; 408-,62'1-30.94 c�gupta@shashicorp°.. c.o
SIRE T D E s erre,STATE,.ZIP CUPERT -NO, A 9.5 0.,1 rAx 4 0,8'-99 6'-2 7'2;9:
'STEVENS CREEK� :BLVD', 433-1 I C
CONTACT'NAMEPHON' A
ROBERT SAUVAGEAU F4.15-8A1-90'9'0 lolDS@ry'sarchitects . com
STREET ADDRESS 10 MONTEREY :BLVD CITY.ST IP FAx 4.i 5-8,4;1=-9 0'8 9
;FRANCI,S;CO, CA 9.4,131
❑OWNER' ❑ OWNER-BUILDER ❑ OWNER:AGENT ❑ CONTRACTOR.: ❑'CONTR.ACTOR'AGENT �. ARCHITECT ❑ENGINEER ❑ DEVELOPER ❑ TENANT
CON rRAC'rOR'--NAME ", LICENSE NUMBER- i LICENSE TYPE RUST LIC#
COtitPANY_NAME - E-MAJU FAX
404 d
STREET.ADDRESSCITY STA"TE,ZIP' .t � BYO PHONE
,
ARCHITECT/ENGINFFR:,NAME -" -"' BUS:LIC# !�
:ROBERTAU
SVAGEAU LICENSE-NUMBER C 110 3;1
COMPANY,NAMERYS' ARCHI-TEC;TS� E-MA-1LBobS@ryaarchit`ects.com FAx 415,x=84,1=9089.
STREET ADDRESS 10 MON.TER'EY BLUR CITY; -9,090,
ZI 415'-8'41
PF RANO I S:COPHONE,, CA 9 4131
DESCRIPTION OF WORK - - - - "' -
NEW SUBSTRUCTURE; CONS,ISTING, OF UNDERGROUND PARKING` FOR ;FUTURE'
,SUPERSTRUCTURE HOTEL. SUPERSTRUCTURE TO BE UNDER. SEPERATE PERMIT.
EXISTING USE 5 �- PROPOSEDLSE ,.CON T .'TYPE HISTORIES, .. -L �,I OFFICE UbE O 4�Y
COMMERCIAL COMMERCIAL 1
p
".'OCC ^:}TVPE•- '-`DESCRIPTION
EXISTG; 'NL'\V FLOOR, DEMO TET AREA
AREA- AREA ( 'AREA NET.AREA ?C�
BATHROOM 'KI'CI1EN; OTHER
-
RE610DEL AREA .` __.- -�
_ �REMODEI,AREA REMODEL AREA
PORMAREA. DECK AREA TOTAL DECK/PORCh6ARL'A GARAGE AREA:❑ DETACH -_ -2 d �
_ x v. a t�
❑ ATTACH r �
VnWI;I,I,ING UNIII. IS"A SECOS D,UNIT ❑❑YIti� SIDDITI STORV ❑Ylici -' q a• ��, �d � 'y� ,�,' A �t '�. -
-,S. -_ ._- b 'tea 8 E
BEING ADD ED'! NO' ADDITION?
E1-N,)
'Pia'-nl u'I n1ION •vee n yrs n wnmI cofwor II�r,(N'�i w`s Nnnrl RECEIVEDB � '� A TO A�-CATION a� I•..
-, ❑- ANNLNI�AI PRnVAI.I 'I''"k `-OL�� T /-r
PLANMN(APPI:.q Nn II fI_N UUN\J
By`Ty,si'gn_ature'below;-I.certify�to,each,ofthe following: I ain the property ov4neror authbiizedIagentto act:onithe"property owndr's.6ehalf. I have'read;this
application andlh'e`infor_ination I hay pro��idedis correct.�I have�r_ead,the Description of WoJ_k and verify`it-Is'accuraie, 1-agree to comply wiih_all applicable local'
ordinances,and''state'laws=relatingtb,buildingconstructioi. Iauthorize.representativesofCupertino,toenter,th"c,above-id ntifie pFoperty-toCinspecnon;purposes!,
SigiiatureofAppl-ican[/Ageht — Date:, DG,
-SUPPLEMENTAL INFORMATION RMUIRED
U ""
RO ;TIiK§1,IP..,,
Ne\v SFD or,Multifamily dwellings: Apply-for demolition permit for ^^ '
-- ❑;''OA ER THE COIINTER� 'CJ B1jILDINC PLAN REVIEW�g
existing building(s): 'Demolition permit is required prior to issuance of building f� 1 WO
penii4jbr,new building. ❑ ExPRFss g I nNNtNc PLAN REQ tEw
Commcrcial,BI'dgs. Provide a completed Ilazardous,Materials Disclosure A NII,
�� �L5'P�uBLrc won s�E
lonnif`ariy.I Iazardous Materials are being used,aspart'.ofthis project. r17,
Copy,of Planning Approval Letter or Meetiiig�with Planning prior to �' a d
❑: MAJOR - SANITARY SEWER DISTRICT
aubmrttal of Building Permitt.application, r f T
IRONMEH
131dgApp_20'U.doc revised'03/16/11
CITY OF CUPERTINO
FE- ESTIMATOR-BUILDIN:G DIVISION
ADDRESS: 10165 n. de:anza blvd. DATE: 06/03/201'1. REVIEWED BY: bob s.
APN:BP#�:, "VALUATION:: .$2,'000,,000
"PERMIT TYPE: Building Permit PLAN.CHECK TYPE:
New Construction
.PRIMARY Civil/R'eligious;activities' PENTAMATION
Commercial'Building 1 S2
USE: inBQzone. Q`Yes' Q,No PERMIT'TYPE:
WORK construct new substructure'for future hotel
SCOPE.
TYPE OF FIL' REA
OCCUPANCY TYPE: PC"FE,ES PC FEKID BP-FEES BP,FEE ID
CONSTR. s.f.'
iA2 , 9S 2(Low-Hazard) ; B .0,;656.4;71'92PLNCK $22,807.31 1"WNs
TOTALS: 29,293; $10:6,56 4722,867-81
�3
"4hili,31
.3,a
Ll,
r
NOTE:T/iesef ees are basedion theprelimifiarypin ormadon,available°and'are onl do estimate. Contdct,the•De tor`addnTin o.
FEE ITEMS(f�.e lZe's�ilutit>n r79 ns/.ff ,',r.'IO.. FEE' QTY/FEE 1VIISG.ITEMS
Plan.ChoOk Fee:,. $10;656:47 Selectsa,Ivlisa`Bld'g/Structure
Suppl.PC Fee D Reg. O.OT O,;Q hrs $0.00 or:Elemenf of'a.,Building
PM;bTian;Clieck: $0.00
Permit F6e- $221,867.31
Suppl..-Insp..Fee`4@-Reg. G-OT 0.0' ahrs $0.00
PME Unit;Fee: $0.00
P1VI'E.Permit Fee $0.00
Constr'T,ax; •9B09NST4XC
Acoustical Fee':, 0 Yes E)'No $0:00 0'
Work Without,Permit? O,yes :.No $0.00
Planning-F ee:'' PLI oNGRIVGC' $7,323.25 Select a Non=Residential-
Building or.Structure
A
Str'or aylt�ti n:Fee'. IBSUSMICQ $420:;00 Select,an Administrative Item
Bld( Stds;Commission tee LBCBSC` $$0:0.0
SUBTOTALS = $0:00 � TOTAL FE
In E
•.• _ ,a ,,,. ,,,,. ..I .r i+ a ,..a,t:- - ' 3423>n - -
Revised'04/29/2011
7 - 11